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良性前列腺增生药物治疗继发性性功能障碍的影响与管理

The impact and management of sexual dysfunction secondary to pharmacological therapy of benign prostatic hyperplasia.

作者信息

Gandhi Jason, Weissbart Steven J, Smith Noel L, Kaplan Steven A, Dagur Gautam, Zumbo Anna, Joshi Gargi, Khan Sardar Ali

机构信息

Department of Physiology and Biophysics, Stony Brook University School of Medicine, Stony Brook, NY, USA.

Department of Urology, Stony Brook University School of Medicine, Stony Brook, NY, USA.

出版信息

Transl Androl Urol. 2017 Apr;6(2):295-304. doi: 10.21037/tau.2017.03.57.

Abstract

Benign prostatic hyperplasia (BPH) is one of the most common genitourinary complications in men over 50 years of age and typically presents with lower urinary tract symptoms (LUTS). Classes of medications include α1-adrenoceptor blockers, 5α-reductase inhibitors, and phosphodiesterase 5 inhibitors. Today, α1-adrenoceptor blockers and 5α-reductase inhibitors are often combined to give a synergistic effect. A review of the current literature identified several adverse sexual side effects, including erectile dysfunction (ED), decreased libido, orgasmic disorders, and ejaculatory disorders. We believe it is important to know the extent of these side effects, as the clinician and patient will need to decide the cost of improved voiding symptoms. The chief adverse effect is ejaculatory disorders, including the absence of ejaculation. Clinical consideration for BPH should include the elements of male sexual function, patients' age, and the characteristics and comprehensive effects of each group of drugs. Methodological bias in clinical studies, such as the subjective evaluation of the sexual side effect, makes it difficult to determine the ideal drug for treatment.

摘要

良性前列腺增生(BPH)是50岁以上男性最常见的泌尿生殖系统并发症之一,通常表现为下尿路症状(LUTS)。药物类别包括α1肾上腺素能受体阻滞剂、5α还原酶抑制剂和磷酸二酯酶5抑制剂。如今,α1肾上腺素能受体阻滞剂和5α还原酶抑制剂常联合使用以产生协同效应。对当前文献的综述发现了几种不良性副作用,包括勃起功能障碍(ED)、性欲减退、性高潮障碍和射精障碍。我们认为了解这些副作用的程度很重要,因为临床医生和患者需要决定改善排尿症状的代价。主要的不良反应是射精障碍,包括无射精。对BPH的临床考虑应包括男性性功能、患者年龄以及每组药物的特性和综合效果等因素。临床研究中的方法学偏差,如对性副作用的主观评估,使得难以确定理想的治疗药物。

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